Individual
DR. ELAINE J. WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 SAINT VINCENT CIR, NEUROLOGY LAB, LITTLE ROCK, AR 72205-5423
(501) 552-4930
(501) 552-4205
Mailing address
10 IRON HORSE RD, LITTLE ROCK, AR 72223-9501
(501) 416-8112
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
C-6076
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112472001
—
AR
Enumeration date
05/23/2006
Last updated
09/11/2012
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